靳三针调神针法治疗卒中后焦虑的疗效观察及对下丘脑-垂体-肾上腺轴的影响OACSTPCD

Objective To observe the clinical efficacy of the spirit-regulation method of Jin's three-needle therapy on post-stroke anxiety and its effects on the hypothalamus-pituitary-adrenal(HPA)axis.Methods Fifty-four patients with post-stroke anxiety were divided into spirit regulation(Jin's three needle therapy)group and sham-acupuncture group according to the random number table method,28 cases in the spirit regulation and 26 cases in the sham-acupuncture group.The patients of the two groups received the same regimen of basic medication and rehabilita-tion,and the same acupoint prescription was adopted,including Sishenzhen(extra points,1.5 cun to Baihui[GV20]at 3,6,9 and 12 o'clock positions),Shenting(GV24),Yintang(EX-HN3),and bilateral Shenmen(HT7),Sanyinjiao(SP6),Hegu(LI4)and Taichong(LR3).The true acupuncture was delivered in the spirit regulation group and the sham acupuncture operated in the sham-acupuncture group.One treatment lasted for 30 min,once daily,5 times a week.The duration of treatment was 3 weeks in the trial.Before treatment and on day 10 and day 21 of treatment,the changes in the score of Hamilton anxiety scale(HAMA)and that of National Institutes of Health Stroke Scale(NIHSS)were compared between the two groups separately.Using ELISA,the contents of adrenocorticotropin(ACTH)and cor-tisol(CORT)in the serum were detected,and the adverse reactions were recorded.Results In the within-group com-parison before and after treatment,HAMA score and NIHSS score dropped on day 10 and day 21 after treatment in the spirit regulation group(P<0.05);HAMA score and NIHSS score in the sham-acupuncture group were decreased on day 21 of treatment(P<0.05).After 21 days of treatment,HAMA score and NIHSS score in the spirit-regulation group were decreased significantly than those in the sham-acupuncture group(P<0.05)and the contents of ACTH and CORT in the serum decreased when compared with those before treatment and those of the sham-operation group(P<0.05).No ob-vious adverse events occurred in the spirit-regulation group and the sham-acupuncture group.Conclusion Using sham acupuncture as a control,it is preliminarily confirmed that the spirit regulation method of Jin's three-needle therapy is effective on post-stroke anxiety.In association of the downtrend of serological indicators,it is speculated that the underlying mechanism of this therapy is related to HPA axis.